Archive for April, 2010

“Create an organization that’s so effective that you can’t afford not to belong.”

That’s the guiding principle of the Council for Medical Specialty Societies (CMSS) and AAHPM is their newest member! This month, Laura Davis, AAHPM Director of Marketing and Membership, and I represented AAHPM at the CMSS spring meeting in Washington DC.

What is CMSS and why did AAHPM leadership decide that it was important to participate? CMSS represents the needs of physician specialists and subspecialists in American health care. And, with complicated issues like the medical home and graduate medical education slots on the table, they represent an important voice. I liked their two overarching goals – (1) to create a culture of performance improvement and (2) to model professional and ethical medical practice. And they’re taking action. During the April meeting, CMSS approved a code for ethical interactions with health-care companies.

Michael Hash, Senior Advisor HHS Office of Health Reform and liaison to the White House Office of Health Reform, talked to the Council about the recent health reform legislations. He emphasized that Medicare and Medicaid will both focus on the subset of patients with multiple advanced chronic diseases. Hello?? Did someone say “Palliative Medicine?” On the GME issue, he did not expect any increase in the number of “slots”; instead, legislation is focusing on loans, loan forgiveness, and National Health Service programs. And last, he asked that physicians actively support Don Berwick’s nomination as director of CMSS – look for legislative action alerts!

Tom Nasca MD, CEO of ACGME spoke next about upcoming ACGME recommendations regarding resident duty hours. He strongly urged physicians to support the ACGME proposals, noting that, if the medical profession fails to act, someone else (i.e., the federal government) will do it for us.

Two panel discussions presented issues regarding the Patient Centered Medical Home (PCMU), the meaningful use (MU) of health information technology (HIT) – it’s Washington, loads of acronyms – and their intersection. I found a couple of useful take-home messages. First, current EMR (electronic medical records) are built to coordinate billing, not patient care. It’s SO true, but somehow I had missed that point before – I can be slow. Second, a new EMR needs to collect data on practice improvement, because performance measures are expected to be integral to proposed health care changes. And third, your EMR should support care coordination, the core principle of the PCMH model.

No one is quite sure what the PCMH model will look like, but it’s expected to follow NCQA guidelines. There’s talk of the “medical neighborhood” that includes specialists and subspecialists. And it’s likely that we’ll see non-physician providers (NPs and Pas) as PCMH practitioners soon. AAHPM needs to continue active discussion of how HPM physicians might fit into the PCMH model – Chad Collas and the Public Policy Committee are already at work.

Membership in CMSS is just another example of how AAHPM is working to meet members’ needs in a changing health care environment! Stay tuned for more. And leave your comments on these issues – we need to hear from you!!

Hospice is an Integral Component of Palliative Care

I’m excited to be a part of the NHPCO Leadership and Management Conference in Washington, DC among colleagues who are so dedicated to the field of hospice and palliative medicine. I’m energized by the conversations in the hallways and the buzz that’s going on in the educational sessions. However, I was disappointed by the comments in Thursday’s plenary session inferring that modern palliative care has turned its back on hospice. Nothing could be further from the truth. A critical and integral component of palliative care is hospice. Many of us in the field have worked hard to help health care professionals, the public and the media understand that palliative care is appropriate for all persons living with a serious or life-threatening illness and their families. To suggest, otherwise, or to suggest that there are leaders in palliative medicine who want to remove hospice from the continuum of palliative care is inaccurate. As the President of AAHPM, I can say without hesitation that the Academy is committed to ensuring high quality palliative care in all settings – most notably hospice.

R. Sean Morrison, MD FAAHPM
President
American Academy of Hospice and Palliative Medicine

ReachMD Partnership Sounds Like a Success

Have you heard yet that AAHPM has partnered with ReachMD, an innovative communications company, providing thought-provoking medical news and information to healthcare practitioners? More importantly, have you listened?

Established to help increasingly time-constrained medical providers stay abreast of new research, treatment protocols and continuing education requirements, ReachMD delivers innovative and informative radio programming via XM Satellite Radio Channel 160 and online streaming developed by doctors for doctors.

The Perspectives in Palliative Medicine series has been a huge success. With over 650 people downloading shows and others listening at home or in their cars, so many are tuning in to hear about key issues in palliative care. The latest programs,, hosted by AAHPM Executive Vice President Porter Storey, MD, include :

The Challenges to Pain Management in Geriatric Patients – 04/12/2010, with R. Sean Morrison, MD
Religious Issues Affecting End of Life Care – 04/05/2010, with Richard Payne, MD
Palliative Care’s Role in Treatment of the Seriously Ill - 03/29/2010 with Russell K. Portenoy, MD
Warning Shot: How to Deliver Difficult News – 03/22/2010, with Gail Austin Cooney, MD.
We are proud of our members who have done such a wonderful job representing the profession. If you haven’t listened yet, check it out, if you have, share your thoughts with us!

Jen Fuhrman
e-Marketing Manager

AAHPM

Pandemic Palliative Care

At the Annual Assembly in the session on Pandemic Palliative Care we discussed the increasing recognition of the role that HPM physicians will be expected to play in a disaster or pandemic. We also discussed the inability of the US to effectively protect the public health with quarantine measures. The AMA News today emphasizes this point.

Obama Administration scraps plans to implement quarantine regulations.

USA Today (4/2, Young) reports, “The Obama Administration has quietly scrapped plans to enact sweeping new federal quarantine regulations that the” CDC “touted four years ago as critical to protecting Americans from dangerous diseases spread by travelers.” Under the proposed regulations, the federal government would have the authority “to detain sick airline passengers and those exposed to certain diseases” for “three business days.” In 2007, CDC Director Julie Gerberding “testified before Congress that the proposed regulations would improve the agency’s ability to identify exposed passengers quickly.” But, the regulations were withdrawn by HHS “after discussion across the government made it clear” that additional “revision and reconsideration is necessary,” according to CDC spokeswoman Christine Pearson.

With no quarantine planning and no defined “duty to serve” as our Canadian colleagues have, how will we:

1) Effectively protect patients and healthcare workers from a deadly contagious disease,

2) Continue to care for the vulnerable HPM patients in our charge and still help palliate the symptoms of a large numbers of new dying patients, and

3) Ensure the availability of a healthcare workforce during and after such a disaster?

What this means is that we will each need to address these issues on a local level and push through the “deer-in-the-headlights” mind-numbing “lets think about something else” attitudes that are not serving us well, either locally or nationally.

Other thoughts?

Porter Storey MD